Archive for June, 2007

Again, my medical professional friends and relatives, please let me know if I got something wrong. As I said, our medical team taught us well, but it is entirely possible I lost something in my interpretation of the facts.

We celebrated a big day this week: one year since Henry came home from the hospital.

Our big celebration consisted of sitting in the backyard on a steamy hot night with a cold beer, watching Will laughing and jumping through the sprinkler and cheering Henry as he chased his rubber ball, all while marveling at how differently fragile life felt just a year ago. And then we turned on the grill and explained to Will that beer is a GROWNUP drink and he wouldn’t like it anyway.

I left you in Part 2 as Henry was wheeled off to his ambulance, mostly because I needed a break at that point. And, truth be told, it was probably the lowest point of his illness, so anything after that will be more upbeat. It was just so unbelievably hard to process that our robust 36-weeker, hardly a “real” preemie, went from having his breathing monitored overnight as a precautionary measure to this unimaginable scenario.

Name tag on his warmer at the first hospital, made by his nurse practitioner.

When we got to Yale, his nurse, an experienced NICU practitioner, didn’t pull any punches with the gravity of his condition. She hugged me tight and said, “We are doing everything that can be done for Henry. Now he just has to decide he wants to be here with us. And he will.”

Oscillating ventilator shaaaaaaaaking away at 700 breaths a minute.

We watched as he labored on the oscillating ventilator, despite his morphine drip to keep him completely sedated — he had already been dosed with morphine and Ativan while on the conventional ventilator, but the experience of being on the oscillator, rapidly puffing the lungs with nearly 700 “breaths” a minute is such an inhuman way to breathe that total sedation is essential.

His nurses there were as wonderful as the ones we had left at the smaller hospital. Our first nurse there was the most incredible blend of skilled neonatal clinician, psychotherapist, engineer, educator and friend, orienting us to the harsh realities of having a baby at this busy, urban hospital—and so many of his nurses there shared similar characteristics. Oversubscribed by more than 10 babies when Henry was there, his nurses still found time to make a name tag for his warmer and share some of kindest gestures I could imagine.

One nurse on the overnight shift exclaimed when I called at 2 a.m. to check in, “I just met Henry tonight, and he is such a Henry! What a perfect name for him!” I don’t know what my silent, intubated and sedated infant did to live up to his name, but her warm words gave me confidence and inspiration—permission to imagine Henry as the healthy baby he would ultimately become.

On the oscillator, with chest tube set to water seal.

And finally, after just a few days there, his attending physician changed our entire outlook on Henry’s illness with the first guarantee anyone had given us about him: she gave us the daily update after rounds one morning, and then reached over and patted my hand, saying, “This is FIXABLE. It will take a while, but Henry is going to go home with you, and he is going to be just fine.”

Henry received three more doses of surfactant while on the oscillator, and we watched and waited. His desats were still too significant to hold him, but after three days on the oscillator, we registered the first real victories of his newborn course: they began to wean down his settings and he tolerated it, while a head ultrasound revealed normal condition with no brain bleeds. His chest tube was set to water seal (the last step before removing it—the water allows his team to watch for bubbles, like in a tire with a hole), and the biggest news of his young life—his team cautiously stepped him down to the conventional ventilator, keeping the oscillator tube at the ready for the first 24 hours.

That same day, Henry’s nurse looked at me and said, “Wanna hold him?” I was terrified to even try, but she explained that everything with these newborns is a test—take something away and see if the baby can take it. Or subject them to stress and see if they can manage to hold their sats, or their heart rate and body temperature. He was still sedated, so she and the attending physician decided it was a good time to give it a try.

And it was wonderful.

I had only held him for a short moment after his birth and then not again since.

Holding Henry for the first time since birth while his doctor looked on.

Walking through the maze of warmers and isolettes of the open ward, it was hard not to notice the astoundingly small micropreemies populating the room, including a 25-weeker whose entire foot was the length of my THUMBNAIL. And I don’t have long fingernails. I look at my thumbnail now and can hardly believe it. I hope that baby had an outcome as good as Henry’s.

Henry spent another two days on the vent at the larger hospital, and then with babies stacking up to the rafters at the acute care NICU, they transported him back to our local hospital NICU. We were thrilled to have him back there.

And after another day there, Henry ticked off a few more milestones: he traded the ventilator for his old friend, the nasal canula, he began the hard work of kicking his morphine habit after his days of sedation (may you never have to witness a newborn with withdrawl tremors) and snuggled with Dad for Father’s Day. He struggled a little for a few days after extubation, but a few rounds on the nebulizer with Albuterol, plus some stern pep talks from his nurse practitioner helped him avoid reintubation. At the same time he received doses of a diuretic, and the puffy, immobile baby we had seen on the vent started shedding water to look more like the newborn we met at birth.

Henry off the vent and on supplemental oxygen via nasal canula — the tube in his mouth is for feedings. The heart is from his lovely, wonderful nurses who put love in everything they do for our babies.

Now that Henry had decided to work on this breathing thing on his own and was ending his course of IV antibiotics, it was time to start talking about the all-important checklist of things that Henry had to accomplish to go home. He had to hold his sats at a target level (97-100%), he had to get off the radiant warmer and hold his body temp in an open crib (the plastic bassinettes used for newborns in regular maternity rooms) and most importantly, he had to learn to feed. The complicated task of sucking and swallowing while breathing can even be a challenge for some healthy full-term newborns, and it is especially tough to coordinate while still learning to breathe. His first feed was 12 ccs of breast milk delivered via syringe down his nasogastric tube, and if you are wondering what 12 ccs looks like, you wiped it off the counter the last time you did the dishes. But still!

Henry with eyes open for the first time! Day of life #13

We tried nursing and bottle feeding later that day, but was he was still too sleepy and uncoordinated to breathe and eat at the same time. But with the help of his nurses and our excellent lactation consultant, we persevered, and within days Henry was beginning to get the idea. At the same time he was shedding equipment right and left—his umbilical arterial line was removed, his IV was removed, his chest tube was removed and finally, he was breathing room air ON HIS OWN.

Henry looking like a real baby—dressed and swaddled, no breathing support, with just the NG tube for feedings and his monitor leads under the blanket.

Now that he was learning to feed, the final hurdle was to get him to take enough milk without having to supplement via gavage feeding, down his NG tube. The pattern was to feed until he was exhausted and asleep (about, well, a minute), then hold him while supplementing his feed while he slept off the effort. When I arrived one evening to start his now nightly bath and weigh-in, his nurse greeted me with good news—if he had gained any weight in the last 24 hours, we had the go-ahead to remove the NG tube and proceed with bottle and breastfeeding exclusively.

We stripped him, put him on the scale and….one gram! He had gained one gram in 24 hours. His nurse hugged me and said, “That’s a weight gain in my book!” And so Henry got rid of his tubes, and was left with just monitor leads. It was truly remarkable to see him wearing clothes and swaddled like a regular newborn.

Once Henry was well enough to be covered, his nurses dressed him in fetching preemie outfits from the NICU wardrobe, complete with coordinating blankets. This handmade green blanket came home with us as a reminder of the warmth and comfort he received at our local NICU.

As Henry began to feed, I spent overnights in the family room on the unit, and one night got a special bonus—written permission from the attending to try “rooming in”—Henry slept in his bassinette in my room while the night nurses stayed vigilant on his monitors. It was the most wonderful and scary feeling to be alone with this baby for the first time—for his whole illness we had just felt like bystanders next to the clinicians who were really taking care of him, and now, finally, it was MY job to take care of him. It was also the first time since birth that he had ever been in the dark.

Taking off the monitor leads.

His rig at the beginning—day of life #2

Same room, look at the difference in equipment around him! Day of life #16

Henry continued to improve his feeding skills, slowly but surely, and his doctors and nurses starting saying that magic word—HOME. He still was a sleepy, sleepy baby with sometimes too rapid respirations, but he was feeding, holding his body temperature in his open crib and holding his sats between 98-100% on room air. He passed the car seat challenge that all NICU babies take before discharge (an hour and a half on the monitors while sitting in his car seat), and it was time to take this boy home.

And so we did.

Henry in his first hour home, day of life #16.

Will (22 months) and Henry (16 days), together for the first time.

And as a little preview of his one-year slide show still to come, I leave you with this. Apologies for the terrible cinematography and hack editing job!

But I wanted to post because the theme today at Picture This is “begin.”

And it would have felt like a great beginning to post the end of Henry’s story, but instead I will post this image, taken in Henry’s first hour home from the hospital, one year ago. Because this feels like the best way I can interpret “begin.”

What I have finally figured out in trying to write about Henry’s newborn illness is that there is no possible way to cram the details into a few blog entries. And, as it turns out, it isn’t necessary. I mean, do you really need to read about each hourly crisis a whole year later, especially when you already know the happy ending? I didn’t think so.

For me, writing about Henry’s medical misadventures means picking out the moments that defined the experience for us, all those moments leading up to the best outcome we could have imagined: a thriving baby boy. And in fact, the only way I CAN write about it today is because of how it all ended. My heart aches for the families of preemies without a happy outcome, and I will never take for granted that we weren’t one of them.

Writing about it now is also an opportunity for the sciencewriter in me to learn a little more about Henry’s illness, now that I can actually stand to read medical web pages about newborn respiratory disease just PEPPERED with stats on infant mortality. Medical types and longtime viewers of ER, you’ll dig the jargon and medical links here; my sincere apologies to the rest of you. There is just no way to talk about this stuff in English. And medical professionals, if I got something wrong, please be sure to let me know. Henry’s medical team taught us well, but it’s entirely possible I lost a little something in the translation.

Henry arrived at 11:15 p.m. on Sunday, June 11—blue and one month ahead of schedule, but perfect, as far as we could tell. Since Will had languished in my arms for what felt like hours after his birth, I was frustrated that Henry was kept across the room from me in the minutes after his birth—I was too dazed to understand the nurses huddled around him were giving him oxygen and becoming concerned with his desperate efforts at breathing.

Henry, 10-minutes old, June 11, 2006

Before long, one of the practitioners from the Newborn Intensive Care Unit arrived to evaluate his increasing respiratory struggle. To my secret relief, Baby Boy (as he was known then) was transferred to the NICU about 45 minutes later—his terrible, labored sounds were scaring me, and I was starting to understand he wasn’t ready to be with us.

Our nurse came by with a Polaroid of Henry on the unit, and I was shocked at the change. Instead of the sweetly swaddled newborn I had held briefly just an hour ago, he was laid out bare and exposed on a radiant warmer, with what looked like a snorkle covering the little face I had hardly seen. He was draped in wires and tubes, and the baby that had seemed so large and robust for a 36-weeker now looked painfully small.

Henry at six hours of life, measuring 18 inches and weighing 5 pounds, 14 ounces on arrival at the NICU.
(Scale is everything—that’s a preemie-size diaper.)

In the morning, we called surprised family and friends, telling them about his arrival, and what we believed to be true—that this was a minor setback, maybe a little fluid in the lungs, and he ought to be just fine in a day or two. I had no idea then Henry wouldn’t be coming home with us at the end of my 48-hour hospital stay.

So what was wrong with him?

As one of his practitioners explained to us, “Newborns have a fairly limited repertoire. This (“this” being rapid breathing, grunting, retracting and low and/or unstable levels of oxygen saturation) is pretty much what they do when they are in trouble, and it is up to us to figure out what is causing it.”

She went on to explain that when a near-term, seemingly healthy baby with Henry’s symptoms arrives in the NICU, the one of the first things considered is transient tachypnea of the newborn (TTN), also known as wet lungs. It is usually just a mild respiratory problem, characterized by rapid breathing, that begins after birth and lasts about three days. It can be more common in babies delivered via c-section or in a very rapid delivery like Henry’s, because, well, they just don’t get all that fluid squeeeeeezed out.

His medical team hoped to pin TTN, the least complicated of newborn respiratory problems, on him, but Henry’s increasing need for breathing support and increased episodes of oxygen desaturations (“desats”) quickly trampled the benign idea of a little extra fluid in his lungs. At the same time he was started on a ten-day course of IV antibiotics for presumed pneumonia and sepsis.

Henry’s neonatologist, a truly extraordinary doctor that spent hours with us, patiently spoke with us time after time in those first 40 hours as Henry’s condition worsened. As each update session ended, he would always ask, “Do you have any other questions for me?” Our biggest questions were the most basic: “What does he have? What is wrong with him and why are we here?”

Just hanging out

The answer was surprisingly unclear. We learned there is really no easy way to rule out pneumonia in a newborn with Henry’s symptoms, so he was treated for it whether he had it or not. Equally as likely, he showed up at the party with respiratory distress syndrome or RDS, the more baby-friendly term for respiratory failure of the newborn or the really old-fashioned moniker, hyaline membrane disease. Whatever you call it, it is a general term for the breathing difficulties endured by lungs too immature to produce adequate surfactant, an important substance produced in the lungs that helps the air sacs stay open. A developing baby naturally produces this necessary substance, BUT not until the last few weeks of pregnancy.

So how do you fix it?

When Henry first arrived in the NICU, he was started on supplemental oxygen delivered via nasal canula, but with a few significant desats and “dusky” episodes (a nice way to say your baby turned blue), he was switched to the snorkle, N-CPAP, which stands for nasal continuous positive airway pressure. We learned that CPAP is still a fairly mild form of respiratory support—a baby on CPAP will initiate every breath himself, while the pressure of the machine keeps his airways open as he exhales. The respiratory support is provided to keep the baby breathing while the lungs heal (if it is pneumonia) or start producing surfactant (if it is RDS).

But despite the support of CPAP, Henry continued having more desats. (As you sit reading this, you are probably “satting” near or at 100% oxygen saturation in your blood. The goal for Henry’s plan of care was to keep him between 90-100%. His desaturations, or “desats” were dipping into the 80s and 70s.)

We had learned to change his diaper around his tubes and leads and check some of his basic vitals during “hands-on” care, the scheduled time for changing, examining and handling babies in the NICU so they can get uninterrupted rest at other times, but he had become so fragile that even the stimulation of a diaper change sent his sats plummeting downward. Our physical contact with him was now limited to laying a hand gently against his skin without patting, rubbing or moving. The thing we wanted to do most, to hold him and touch him, was one of the most devastating things for his survival.

Careful monitoring by his team, plus more chest x-rays than I can count confirmed that Henry had a whole new layer of complications threatening his ability to breathe: on his second day of life, he developed both a pneumothorax, (an air leak into the space between the chest wall and the lungs) and a pneumomediastinum, an air leak into another part of the chest. The pressure of the air leak collapses the lung and affects the ability to breathe, so at 10:15 p.m. on June 12, at 23 hours of life, Henry’s doctor put in a chest tube (which is just what it sounds like) to drain the air leak while the lung healed.

Henry’s chest tube is attached to that giant hose on the right, evacuating the leaked air so his lung can reinflate.

After that, it was clear that Henry wasn’t heading home any time soon, so his team celebrated his 24th hour of life by placing an umbilical arterial line, which sounds terrible, but is really a kind way to draw blood, administer meds and give nutrition to babies in it for the long haul.

The next morning, just before dawn, Henry’s nurse practioner flew into our room to advise us of his recent crisis. We were catching a few hours of sleep, our first since his birth. She pushed the door open so hard it slammed against the wall, and in those seconds before she spoke, I tried to will her to say words that I could bear to hear.

Despite the chest tube and the support from CPAP, his sick little lungs just couldn’t do their work, and the effort became too great for him to breathe on his own. At 30 hours of life, after a significant desaturation event (sats below 40% for approximately two minutes) Henry stopped breathing, and didn’t respond to tactile stimulation and blow-by oxygen, so he was intubated and put on a mechanical ventilator. We are forever grateful that Torie was at his bedside before this pre-dawn event, and responded instantly to this emergency, lessening the amount of time his brain was without precious oxygen.

Henry on the mechanical ventilator, 32 hours of life.

Probably the most famous baby ever to succumb to respiratory distress syndrome, as many people told us once Henry was on the mend, was Patrick Bouvier Kennedy, the newborn son of President John F. Kennedy and his wife Jackie Kennedy. Young Patrick, born in 1963, was a near-term baby like Henry, but his tiny, critically-ill body became overwhelmed with respiratory distress, and he died at just 39 hours of life.

Therapies that Henry received, including CPAP, mechanical ventilation and exogenous surfactant might have saved Patrick Kennedy, but they either did not exist or were unavailable in 1963, even for the child of the President of the United States. Since the development of surfactant, survival rates for premature babies with RDS have increased dramatically and these days, most babies with RDS survive. I join legions of parents in thanking my fellow Wheaton alumna, Dr. Mary Ellen Avery, for discovering and advancing the use of surfactants in newborns with RDS. I can hardly imagine how many babies her work has saved.

Despite the chest tube and the full breathing support of the ventilator, Henry’s condition, already critical, continued to deteriorate on Tuesday, June 13. He was given his first dose of surfactant, but his episodes of desaturations continued and his now hourly chest x-rays were suggesting the beginning of another complication, pulmonary interstitial emphysema, and the possibility of two additional pneumothoraces (which I am pretty sure is the plural of pneumothorax. May you never need to know.).

His doctor, who had been managing Henry’s care since his arrival on the unit, came into our room, sat down and said words that are seared into my soul: “We are at the edge of what we can do for Henry here. He needs to be transported to a hospital that can offer the two remaining therapies available.”

It’s odd what you process about times like this. When his doctor inquired if we preferred New York or Boston as options for treatment for Henry, I remember thinking how thoughtful it was for him to ask which city we might like to go live in for a while, and I wondered exactly what criteria we should use to choose. And later, I remember making polite conversation with the EMTs as they waited for their precious cargo to be loaded into the mobile isolette and readied for his ambulance ride. I think I actually asked them about traffic.

But we didn’t have to choose after all, because their first choice, the acute-care NICU in our state, just an hour’s drive away, had a warmer ready for him. Henry’s doctor cautioned us that Yale-New Haven Children’s Hospital would be quite different from the intimate, 12-bed NICU at our local hospital, with constant access to the now-familiar medical team. But despite the sophisticated care he had been receiving, Henry needed a hospital offering a specialized high-frequency ventilator, called an oscillator, to allow his damaged lungs to heal. He needed the experience of a nursing staff used to caring for critically ill babies like Henry and there was the real possibility that he would need an invasive, last resort treatment for sick lungs: ECMO (extra corporeal membrane oxygenation), a heart-lung bypass treatment that takes over for diseased lungs so they can heal.

Preparing Henry for transport

A transport team arrived, comprised of a neonatal nurse, a neonatal fellow and two EMTs. I don’t know that they wanted us there as they did the delicate work of preparing him for transport, but no one asked us to leave, even while his monitors blared warnings of his increasingly unstable blood pressure and sats. Henry’s nurse put a comforting arm around me and handed me tissue after tissue as I wept, watching the tightly choreographed movements of the transport team.

40 hours of life—all plugged into his mobile isolette and ready to roll.

It took nearly an hour and a half to prepare his equipment and stabilize him enough to move him from the warmer to the mobile isolette—each time they were about to move him, his sats would plunge. My heart sank when he held a stable reading for about 60 seconds and his doctor said, “Go, go! Get him moving now!” I’m sure he never meant for me to hear the stark urgency in his voice, but the words are etched forever on my heart. I just kept thinking, like a mantra, they would TELL US if this baby is too sick to survive transport. They would TELL US.

Finally, after administering a paralytic medication to help him through the transport, they plugged him in and started to move. But before they left the unit the transport nurse said, “Wait! He needs a kiss from mom before he goes.” They aren’t big on kissing in the NICU (infection is one of the most deadly complications a preemie can face), so this encouragement was a gift. After a quick kiss, they closed the hatch, and rolled him towards his waiting ambulance.

Last year, Henry celebrated by weaning off the ventilator and snuggling with dad for the first time since his birth.

Father’s Day, 2007

This year, he celebrated with a birthday party and by getting soaking wet with his brother’s new water toy. Just the way we like it!

Thanks to all the wonderful friends and family who joined us yesterday to celebrate Henry’s birthday.

(For birthday party photos, click here or on the 12-month photo above.)

It was a beautiful, emotional, joyous, incredible day for us, and we were so happy to share it with those who had seen Henry through it all. And to those who weren’t with us, but shared your best birthday wishes for Henry, thank you for those, too.

And lest you think I forgot, I am fully aware that I promised a slide show and Part 2. Coming soon, I swear.

Things here will be on hiatus for a couple of days while I keep busy looking for a cure for chronic ear infections (three of them here this week!), guidance on how to make an almost-three-year-old behave (eat, go to bed, etc.) without pulling your hair out and directions on how to decorate the inchworm cake for Henry’s birthday party. Or maybe it will be a sheep cake. And does it really matter, since he can’t eat it anyway.

Advice MOST WELCOME in all areas. PLEASE.

In this meantime, I leave for you some recent photos of the boys, taken by Nicki Pardo.

And yes, this is the WORST EVER job of video editing you’ve ever seen, I don’t know what happened in those first few seconds especially. They’ll show this in film schools everywhere just to say what not to do.

And? I didn’t know this until recently: If you want the little “vimeo” banner to go away while you watch the video, just move your cursor out of the frame. Was I the last person anywhere to figure this out?

And finally, if you are cringing because you have come to me in the past for recommendations on buying a video camera (all two of you) and now you are watching the poor quality of these clips, cringe not: this was shot with the video function of our point and shoot still camera.

Warning: long entry ahead, but what kind of mommy blogger would I be without a birth story, esp. on my baby’s birthday? Come back later in the week if you’re looking for something other than the Henry channel.

The main event for last June 11, as far as we knew, was a visit from grandma and grandpa. Grandpa, with help from Dad and Will, built a new sandbox for Will, while Grandma and I enjoyed watching three generations of males wield hammers together.

The only notable event of the day was the amazing 50-yard sprint I did when I saw Will headed for a patch of poison ivy in the yard. I SO wish I had clocked it, I still can’t believe I ran that fast.

Grandma and Grandpa left for home in the late afternoon, and we headed inside. I felt a few contractions with some power behind them, but I’d had an overnight episode of pre-term contractions earlier in the week, and a pep talk from my midwife had assured me that contractions would be the norm until this baby arrived. And, in fact, she was right.

I parked myself on the couch, and downed a few glasses of water like the books tell you—”Contractions? You must be dehydrated.”

6:45 -7 p.m.

The contractions either subsided a bit or my powers of delusion were stronger than I realized, and I forged on with Will’s bath-and-bed routine while Brian took advantage of the remaining daylight to finish constructing the sandbox lid.

7:15 p.m.

Did Will really used to go to bed this early? With Will in bed, I resumed my position on the couch, and waited for Brian to come in for dinner. I was on the phone with Melissa when I realized that I might want to start timing these contractions, the ones that had resumed at a pretty good clip and with some serious intensity.

8:15 p.m.

I’m feverishly paging through a birth book, looking for something that will tell me I can have contractions this close together and still not have a baby tonight.

8:25 p.m.

I find no evidence to support above theory. Contractions are now 2-3 minutes apart.

8:30 p.m.

I call our midwife. Brian has no idea that I’m calling, because he is now upstairs with Will, coaxing him to sleep (guess 7:15 p.m. was too early after all.) I was fully expecting a “wait and see” reaction from the midwife, and instead she paused and said, “Why don’t you call someone to take care of Will and I’ll see you at the hospital.” I hung up, burst into tears and called Jon and Jenny, our dream team of Will caregivers, who had volunteered to do a trial run with Will the next night while we enjoyed an evening out.

8:45 p.m.

With Will settled, Brian comes downstairs to finally eat dinner. I break the news to him that he has a bag to pack.

8:57 p.m.

Still thinking this could be a false alarm, I puttered around, packing Will’s schoolbag and packing a hospital bag for me, and burst into a new round of tears when Jon and Jenny arrived what seemed like seconds after I called them.

Note dorky stopwatch on my left wrist. My contractions were now between 1-3 minutes apart. I hoped that if I had an accurate timer instead of the numberless wrist watch I usually wear, I’d like the results better. I was wrong.

Also note dorky multi-page document on the care and feeding of Will. Bless them, Jenny and Jon didn’t laugh when I handed them that manifesto.

9:15 p.m.

We leave for the hospital. The contractions intensify to the point where I start to believe I will either have a baby tonight, or will die. Not sure which will happen first.

9:30 p.m.

Exiting the highway and going down the hill towards the hospital, we are struck silent by the large, yellow full moon hanging low over the horizon. I asked Brian, “What IS today’s date?” Because I knew it wasn’t one of the dates I had anticipated for our baby’s birthday.

9:40 p.m.

Contractions are now between 30 and 90 seconds apart. Once again, I have FAILED the first rule of when to come to the hospital, “When you’ve been contracting for one hour at five minutes apart.” What, I wonder idly, are the rules for people like me, who start at less than four minutes apart? We go through the maze of hallways to Labor & Delivery, and the intensity of the contractions reduces me to a crawl. I fully expect to be That Pregnant Lady Who Made It To The Hospital In Time Only To Give Birth Unattended In The Hallway Overlooking The Cafeteria.

9:44 p.m.

Okay, I think I can walk again. Why do they have Labor & Delivery SO FAR FROM THE CAR? Any one who has ever delivered at this hospital will agree with me, I am sure.

9:46 p.m.

I’m led to a bed in triage, walking bent over at the waist and trying not to lay down in the hallway. TRIAGE! Do they think I am FAKING these contractions? Did they not SEE ME CRAWLING on the security cameras outside the door to the unit? Of course they did, they are all just laughing too hard to come get me and bring me to a delivery room.

10:15 p.m.

After a few minutes (or millennia, I can’t remember which) on the monitors there, they actually believe I am going to have a baby soon and I am ushered down the hall to my labor and delivery room. I keep what little dignity I have left, and DO NOT CRAWL.

10:16-11:00 p.m.

Mostly a big blur (I could only get through the contractions with my eyes closed), punctuated by my midwife telling the anesthesiologist, never mind, that I would be having this baby in 15 minutes. I distinctly remember wanting to be part of this conversation, but I was TOO BUSY CLOSING MY EYES. This blurry time ended with my midwife asking if she could break my water. I remember thinking how awfully polite she was about it, and I thought maybe I should stop yelling in her ear quite so loudly.

11:10 p.m.

HOLY BANANAS NOW I KNOW WHY SHE ASKED IF SHE COULD BREAK MY WATER. Because that should be a felony. Everything leading up to this moment was just a dress rehearsal, contractions to talk about at a cocktail party. My entire body is just one big, excruciating contraction, and it is crystal clear to me that this contraction will not cease until this baby is out.

11:15 p.m.

And so, I pushed three times, working harder than I’ve ever done anything in my life, and our little blue Henry arrived.

Oxygen at birth helped turn him pink. We didn’t yet know how much more support he would need.

With Henry’s first birthday next week, I feel like I’ve finally been hit with the super-charged post-partum hormone attack I never had after his birth.

In the weeks after Will was born, my husband would catch me wiping away a tear as I left my sleeping newborn to, say, walk to the mailbox. (You read that right, THE MAILBOX, but during that walk, my inner nut-job mommy was wailing, “This is just the first of a lifetime of moments you will have to leaaaaaave hiiiiiiiiim!”)

But when Henry was born, maybe it was the surprise early arrival, or the fact that this time I really had something to cry about, that gave me an unexpected steeliness in the weeks after his birth. All of my energies, formerly devoted to obsessing over the impact this new baby would have on the delicate sensibilities of my precious firstborn, went to rooting for this little fellow hidden in a tangle of tubes. If that needy, weepy post-partum mommy was around, I never even noticed her.

So now, as I watch him wiggle out of my arms down to the floor and walk away from me (rubbing salt in the wound as he says something that sounds a lot like “bye!”), I am feeling a little weepy and wanting desperately to stop time, something I would love to chalk up to delayed-reaction post-partum hormones. It’s not that we aren’t overjoyed at his accomplishments. We greet each new milestone with cheers and applause, and I’m beyond thrilled that this baby, the one who could hardly lift his head at six months and didn’t sit up until eight months, is showing us that an early arrival really just means a head start.

But it’s just that with each new first comes the grieving of a last. It means greeting a strange new being (with NEEDS! and WANTS!) that has replaced that sweet tiny baby that I keep in my heart, but who is nowhere to be found in the present. And watching Will running, climbing and jumping out of toddlerhood at a breakneck speed reminds me that the pace only increases from here.

So really, I think it just means I miss this sweet six-week old baby, who slept and slept and slept all his days and nights away, until one day he woke up and gave us a smile.

And I miss this six-month-old roly-poly bundle of joy, who cooed and smiled and laughed whenever I walked into the room, but was powerless to move anywhere on his own.

But I guess it won’t be too long before I’m telling you how much I miss this little eleven-month-old maverick, too.

And someday, a VERY long time from now, I might even tell you I that I miss this monkey, too. MAYBE.

Hank and What?

For those of you looking for Anna Sawin's photography blog—you've arrived.

For those of you wondering why on earth it is called Hank & Willie, this blog began many moons ago as an electronic baby book for my wee ones, Will and Henry.

It has long since grown into a photography blog, a food blog, a family blog and so many other things. While I know the blog will continue to evolve and showcase the latest in my life and work, I'm kind of attached to the name.